Public participation in the process of local public health policy, using policy network analysis

Public participation is getting more important that civil society exert their influence to many public policies. However, in health sector, the level of public participation seems weaker than other sectors, and advanced research were usually focused on public participation at the level of national health policy. This study investigated the local public health policy network through two districts, two policy cases, aiming at understanding present state of public participation and exploring the way to activate public participation in local health policy process. Three exploring factors of policy network analysis in this study were actors, contents of interactions, and network characteristics. For the policy making process, this study explore establishing sub-health center, and for the implementation process, metabolic syndrome care policy was explored. Literature and record search was done for the prior investigation and main study is done by questionnaire survey targeted to every participants in organizational level. Participants were found by snowballing method. Conclusions were made that it is not yet activated in public participation to the local public health policy process both decision making and implementation. In decision making process, main actor was public sector(local government and health center) and citizen participation was partly done in accessory topic like location selection in response to their inconvenience of using existing sports programs. In implementation process, the metabolic syndrome care program organized strongly driven by health center that centralization score became almost 100%. It should have more prior discussion with various stakeholder include civil society before making local health policy. And it should be emphasized that formulation of social consensus to participate in implementing local health policy is needed both to the health center staffs and local residents.